Home Therapies Senior Sister

Job responsibilities

1 Clinical Practice

In consultation with the Renal Matron and Consultant Nephrologists, set the standards of care to be achieved within his/her area of control. Ensure that agreed standards are met, identify when they are not and identify factors influencing the non-achievement of standards. Passing this information to the Multi-disciplinary Team for discussion, and work with them to rectify the problem.

Assesses, plans implements and evaluates health related and nursing needs of patients and their families making autonomous decisions in relation to patient care. Changes in all patients condition/behaviour are brought to the attention of the medical staff or other disciplines when appropriate.

Formulate treatment plans and dialysis prescriptions in consultation with nursing team, medical staff and through the use of computer programs specifically designed to optimise patient prescription.

Identify situations where patients may require prompt medical treatment and to act promptly within agreed unit protocol. Treatment may involve the administration of prescribed drugs, orally, intravenously and intraperitoneally. Depending on the severity of condition, organisation of hospital admission may be necessary. The Senior Nurse can facilitate this process by co-ordinating with the Medical Team, Bed Manager and Nursing Staff. He/she will offer support and advice about peritoneal dialysis to Ward Staff and Medical Team during this period of hospitalisation.

When requested by the Medical Team, responsible for demonstrating dialysis options available within the Home Therapies Department to pre-dialysis patients to allow them to make an informed choice of future therapy.

Check patients blood results on a regular basis identify abnormalities and bring to the attention of the Medical Staff for alteration of drug therapy, dialysis prescription.

Provide on Call advice over the phone outside normal working hours on a rotational basis for patients. This involves trouble shooting problems with the dialysis machines during the patients overnight treatment, and/or offering advice and support in times of illness e.g. if a patient should suspect infection outside normal working hours.

Have an in-depth knowledge of the use of equipment used for dialysis therapies and ensure competence of junior staff in conjunction with the Practice Development Team in the use of equipment.

Refer patients to members of the Multi-disciplinary Team, Dietitian, Social Worker/Counsellor; Medical Team should problems specific to their discipline become apparent within discussions with the patient.

Offer advice and psychosocial support to enable patients and their families to influence and participate in decisions concerning their care.

Oversee advice and support extended to patients and relatives by the Nursing Team.

Develop long term involved relationship with patients and carers due to nature of chronic illness. Provide continuing support to adapt psychosocially to their illness and through transition to other dialysis modalities, transplantation or death.

Identify potential risks within the unit, within the patients home and to take the necessary steps to rectify the problem.

The role can involve frequent exposure to bodily fluids, therefore, you must ensure risks are assessed and Health and Safety requirements are met within the unit.

2 Clinical Governance

Work towards latest guideline publication Renal Association Standards, Department of Health and other Government based guidelines.

Assist the Matron and Practice Development Team in the development of Departmental policies and procedures.

Work to ensure the welfare and safety of staff and patients are safeguarded, by ensuring a safe working environment, and create an environment conductive to aid recovery.

Collect, collate, evaluate and report information, maintaining accurate patient records as required.

Act on concerns reported by staff members and or service users.

Take a proactive role in the management of risk i.e. risk assessments, and significant event management.

Ensure that all reasonable precautions for a safe and secure environment for self and others in accordance with Health & Safety legislation are in place, reporting any areas of concern to line manager.

3 Management and Leadership

Responsible for advanced planning of care, and for advanced rostering. Re-rosters staff short term in times of sickness to ensure service is adequately covered.

When responsible for deploying and supervising staff, ensure that the competence of the individual Nurse is appropriate to the care required by the patients. Ensure the care given is achieved in the most effective and efficient manner commensurate with sensitivity to patients needs. Where acceptable standards of care cannot be achieved or maintained because of shortage of time, equipment or manpower, report deficiency to lead nurse

To act up in the absence of the matron when requested, carry the bleep and assume managerial day to day responsibilities for the unit.

Identify and devise agreed policies, procedures and guidelines for the Home Therapy Department.

Work within agreed policies, procedures and guidelines, demonstrating a good role model to other members of the team.

Organise and chair regular meetings for discussions with his/her team members about the planning and delivery of care for their caseload of patients.

Provide support and advice for staff on call as and when needed on a 7-day a week basis.

Responsible for the day-to-day management of the department and organisation of the workload in conjunction with the matron. Encourage an open attitude in working relationships and adopt a team approach to care.

Demonstrates effective leadership skills within the team, developing trust and minimising interpersonal conflict.

Participates and leads in regular Department/Team meetings/Multi-disciplinary meetings at the discretion of the Matron.

Assist the matron in monitoring team sickness and offer support and counselling as required within Health Board policies and procedures. Be available to address any issues departmentally and multi-task as and when needed in the absence of the matron.

To be actively involved with the matron in the recruitment and selection of staff.

Provide clinical supervision to members of the team.

Provide information and advice to support staff to assist decision making.

4 Teaching and Education

Undertake teaching, education and ...